We understand the many time constraints that providers are up against on a daily basis and our goal is to minimize the time you spend on credentialing and contracting. One way for us to provide this service to you with little to no interruptions is to allow us to electronically sign your credentialing documents for you. This includes but is not limited to: Insurance interest forms or letters, Insurance applications, insurance contracts, hospital credentialing, re-credentialing for insurance and hospitals, program renewals and attestations of demographics. We are able to sign through services like Adobe, DocuSign, Capterra and Topaz. We will always ask you or your office contact prior to signing and will make the documents readily available to view before signing and provide an executed copy once completed. If you would feel more comfortable signing yourself, we can also accommodate that, not an issue at all.
For the Signatory Delegation and Authorization please sign the statement below and then sign in the boxes below PREFERABLY in blue pen. Thank you!
By signing this statement, I acknowledge and authorize RSBCHO and its employees to be the designated signatory and to sign standard applications and contracts on my behalf.
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